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Large colon volvulus(Obstruction-Strangulation Obstruction) in Horses

General Description of Signs and Findings
- The degree of pain may be quite variable, with horses having large colon impactions or some displacements showing signs of mild abdominal pain. In contrast, horses with more severe displacements, volvulus or colitis may be acutely painful. It is very common for horses with large colon displacements, volvulus or colitis to have a grossly distended abdomen. Although nasogastric reflux usually is associated with small intestinal conditions, it may be present in horses with large colon displacements that occlude the duodenum. Alterations in tissue perfusion, capillary refill time, mucous membrane color, intestinal sounds and heart/respiratory rates occur in horses with conditions involving the large colon. In general, these alterations are most pronounced in horses with strangulation obstruction of the large colon and horses with colitis. Changes in peritoneal fluid color, cell count and protein content also may occur, generally reflecting the degree of tissue ischemia. It is usually possible to identify impactions, certain colonic displacements and volvulus on rectal examination. Adhesions rarely involve the large colon after surgery. The most common post-operative complications are incisional problems and diarrhea.

Additional information

Volvulus of the large colon occurs near the attachment of the colon to the cecum. Although the condition often is termed a "torsion," the fact that the colon twists on the mesentery between the dorsal and ventral colons makes it a volvulus. It is presumed that movement of the dorsal colon either medially or laterally and downward causes the colon to twist. Presumed to be associated with disproportionate amounts of gas within parts of colon, though this is unproven. Often associated with impending or recent parturition, a grass diet and/or highly fermentable feeds. If the volvulus is <270 degrees, there may be obstruction of bowel lumen without tissue ischemia. If 360 degrees or greater, the condition produces strangulation obstruction of the colon.

The large intestine of the horse. Illustration by Dr. Gheorghe Constantinescu
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